Organization Name: | ALLIE ANDRUS MCCANN |
NPI Number: | 1477809887 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALLIE ANDRUS MCCANN (MARRIAGE AND FAMILY THERAPIST) |
Mailing Address: | 131 Kelly Ave Half Moon Bay |
State: | CA US |
Postal Code: | 940191629 |
Phone Number: | 6505606884 |
Fax Number: | |
NPI Enumeration Date: | 08/03/2012 |
NPI Last Update Date: | 08/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | MFC44433 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |